This invention relates generally to the field of medical treatment, and in particular to the treatment of patients located outside of a medical facility. More specifically, the invention relates to the remote monitoring of patients, and to the remote treatment of such patients based on monitored parameters that have been transmitted to a central control center within a medical facility.
Medical emergencies that occur away from medical facilities are a major concern to medical personnel. The ability to rapidly identify a person""s medical condition and to prescribe and administer appropriate remedies is often a critical factor for successful treatment. However, since most medical emergencies occur outside of medical facilities, proper treatment is often limited by the ability to rapidly deploy appropriate medical personnel and equipment. Merely by way of example, for many people, a significant amount of time is spent within their home or at their place of employment. The time required to deploy trained medical personnel and equipment to such locations can play a significant factor in successfully treating individuals experiencing medical emergencies at such venues.
A wide range of medical conditions may pose a significant threat to the health and well being of individuals. Such conditions may include, for example, sudden cardiac arrest, loss of breath, heart attack or heart rhythm abnormality, and the like. As an example, arrhythmias, such as ventricular fibrillation or ventricular tachycardia, are a significant threat of death if not treated promptly and appropriately. One well accepted technique for treating arrhythmias is the application of a defibrillating shock. However, few individuals have the appropriate equipment or training to properly apply a defibrillating shock when the patient is located away from a medical facility. More importantly, even if such equipment were available, trained medical personnel may still be needed to properly diagnose the patient""s condition and to prescribe the appropriate treatment.
Hence, the invention is related to techniques for remotely monitoring a patient""s condition, diagnosing the patient""s condition, as well as remotely applying appropriate treatment schemes. In this way, patients may rapidly be treated outside of a medical facility, while waiting for the arrival of properly trained medical personnel.
The invention provides systems, devices and methods for remotely monitoring and treating patients suffering from a medical condition or emergency. The invention is particularly useful for patients located outside of a medical facility where immediate access to trained medical personnel is impractical or impossible. According to the invention, the patient is monitored at a remote location where they experience the medical condition. The monitored information is sent over a communication link to a hospital or other medical facility where medical personnel are available to diagnose the condition based on the transmitted information. The monitored information is analyzed by medical personnel and/or by a computer. Control signals may then be transmitted back to a treatment device that is coupled to the patient to medically treat the patient. In this way, the patient may be rapidly diagnosed and treated outside of a medical facility. Once emergency personnel arrive, the patient may be transported to a medical facility for further treatment.
In one particular embodiment, the invention provides a medical monitoring and treatment system that comprises a central controller having at least one communication device for receiving monitoring signals and for transmitting treatment control signals. At least one remote device having at least one communication device for receiving treatment control signals and for transmitting monitoring signals is also provided. The system further includes at least one monitoring device and at least one treatment device that may each be electrically coupled to the remote device. In this way, the remote device may be used to transmit monitoring signals received from the monitoring device to the central controller. The central controller may then be operated to produce and send a treatment control signal back to the remote device to control the treatment device.
The communication devices of the central controller and the remote device may be configured to communicate over a variety of communications links, including, for example, telephone lines, computer networks, including the Internet, cable lines, radio frequency transmission links, satellite transmission links and the like. In this way, the remote device may communicate with trained medical personnel at essentially any location.
The system may include a wide variety of monitoring devices, including, for example, heart monitors, respiratory profile monitors, temperature monitors and the like. Similarly, the system may include a variety of treatment devices, including, for example, positive pressure ventilators, electroventilators, phrenic nerve stimulators, defibrillators, cardiac pacemakers and the like.
In one particular aspect, the treatment device comprises one or more external stimulating electrodes. In this way, the central controller may include a shock control module for sending control signals to the remote device to provide an external defibrillating shock to the patient. The central controller may also include a stimulation control module for sending control signals to the remote device to electrically stimulate the phrenic nerve. Such stimulation may be used to electrically ventilate the patient and/or to assist in lowering the intrathoracic pressure of the patient when performing CPR as described generally in copending U.S. patent application Ser. No. 09/095916 (filed Jun. 11, 1998) and Ser. No. 09/197286 (filed Jan. 20, 1998), the complete disclosures of which are herein incorporated by reference.
In another aspect, the treatment device may comprise a positive pressure ventilator, and the central controller may include a ventilation control module for sending control signals to operate the ventilator. In still another aspect, the treatment device may comprise an external cardiac pacemaker, and the central controller may include a pacemaker control module for sending control signals to operate the pacemaker.
Conveniently, the remote device may include a speaker and circuitry to produce an audible signal or message transmitted from the central controller. In this way, medical personal may remotely provide instructions to a rescuer by speaking into a microphone of the central controller. Further, the speaker may be used to produce warning signals when operating the treatment devices. For example, the speaker may produce an audible warning to xe2x80x9cstand backxe2x80x9d when a defibrillating shock is about to be applied. Optionally, the remote device may include a camera and circuitry to transmit image signals from the camera to the central controller. Conveniently, the central controller may include a display screen to visually display images produced from the image signals. In this way, medical personnel may remotely visually monitor the patient.
In still another aspect, the central controller may include a monitoring screen to visually display monitoring signals received from the remote device. For example, the monitor may display the patient""s heart rhythm in real time.
The invention further provides an exemplary method for providing medical treatment to a remotely located patient. According to the method, at least one physical parameter of a patient that is located away from a medical facility is monitored with a monitoring device. The monitored physical parameter is transmitted in real time to a central controller that is located within a medical facility. A control signal is then sent back from the controller to operate a treatment device that is coupled to the patient, with the control signal being selected based at least in part on the monitored physical characteristic.
Conveniently, the monitored physical parameter may be displayed at the central controller, and then evaluated by medical personnel and/or a computerized analyzer (which may be incorporated into the central controller) so that the central controller may be operated to select and transmit an appropriate control signal. In one aspect, the monitoring device and the treatment device are electrically coupled to a remote device, and the monitored physical parameter is transmitted to the central controller from the remote device. The transmitted control signal may then be sent from the central controller to the remote device to control operation of the treatment device. Conveniently, the monitored physical characteristic and the control signal may be transmitted in real time over a variety of communications links, including, for example, telephone lines, computer networks, cable lines, radio frequency transmission links and satellite transmission links.
In one aspect of the method, the monitored physical characteristic may be any one of a variety of characteristics. Such characteristics may include, for example, arrhythmias, ventricular fibrillation, ventricular tachycardia, end tidal CO2, O2 saturation, inspiratory tidal volume, expiratory tidal volume, patient temperature and the like.
In another aspect, the treatment device may comprise at least one electrode, and the transmitted control signal may be used to control actuation of the electrode to stimulate the phrenic nerve. In this way, the electrode may be used to electroventilate the patient, to increase the negative intrathoracic pressure within the patient and/or to perform electronic CPR on the patient. Further, the transmitted control signal may be used to control actuation of the electrode to supply a delibrillating shock to the patient.
In an alternative aspect, the treatment device may comprise an external pacemaker, and the transmitted control signal may be used to control operation of the pacemaker. Alternatively, the treatment device may comprise a positive pressure ventilator, and the transmitted control signal may be used to control operation of the ventilator.
Conveniently, the remote device may include a speaker, and a signal containing verbal instructions may be transmitted to the remote device to permit the instructions to be recited by the speaker. In another aspect, the remote device may include a camera, and a signal containing visual images may be transmitted from the camera of the remote device to controller for display by the controller.